Pelvic pain can be the symptom of gynecological conditions such as endometriosis, adenomyosis, fibroids or ovarian cysts.
Pain is not a symptom of the hormonal condition PCOS.
But what if you have pain and your doctor discovers polycystic ovaries on ultrasound? Surely, that offers some kind of explanation? Nope. Your pain is not related to that ultrasound finding.
Here are three things to understand.
Polycystic ovaries are not ovarian cysts
Polycystic ovaries are follicles or eggs, which are normal for the ovaries.
You have more eggs when you’re younger, so you’re quite likely to have “polycystic ovaries” when you’re younger. It really just means “many eggs.”
Having polycystic ovaries doesn’t mean you have the hormonal condition PCOS. It actually does not mean anything at all.
Polycystic ovaries can show up on an ultrasound when:
- you’re perfectly normal
- you have PCOS
- you have hypothalamic amenorrhea,
- you have endometriosis, or adenomyosis, or any number of other issues that are the actual cause of pain.
There is such a thing as ovarian cysts that are abnormal structures and can burst and cause pain. Ovarian cysts are not polycystic ovaries.
Polycystic ovary syndrome (PCOS) is a hormonal condition, not a gynecological disease
PCOS is a hormonal condition that is having too many androgens or male hormones. In fact, it’s best defined as the condition of androgen excess when all other causes of androgen excess have been ruled out.
If you have PCOS, you need to lower androgens. That’s what metformin and a no-sugar diet can do but only if you have the classic insulin-resistant type of PCOS. Those treatments will do nothing for pain.
You can have both PCOS and pain but they’re separate issues
PCOS is common. But so is period pain and so the conditions that can cause pain such as ovarian cysts and endometriosis.
It is possible to have both PCOS and period pain.
If your pain is mild, then it should respond to the simple treatments discussed in my period pain post.
Finally, yes. The pill can suppress the symptoms of both PCOS and period pain, but cannot fix either problem.
Ask me in the comments.